Clinical Images: Active neuro-Behçet's disease manifesting as cerebral aneurysm rupture after acute cerebral infarction.

The patient, a 36-year-old man, visited the emergency department because of right limb numbness. Brain magnetic resonance imaging revealed acute ischemic infraction (ACI) in the left thalamus and paraventricular regions (A). The white blood cell count, erythrocyte sedimentation rate, and C-reaction protein level raised significantly. A urinalysis suggested nephritis. Cerebrospinal fluid identified aseptic meningitis. Active neuro–Behçet's disease was confirmed because of a history of orogenital ulcers, a positive pathergy test result, and HLA-B51 positivity. The patient received hormonotherapy and antiplatelet therapy; however, he fell into coma 3 days later. A brain computed tomography scan showed extensive subarachnoid hemorrhage, intraventricular hematoma, and ventricular dilatation (B). Cerebral angiography revealed two irregular aneurysms in the left posterior cerebral artery presenting with a fusiform morphology (C). Cerebral artery involvement in Behçet's disease is relatively rare and can be characterized by either ischemic infarction or hemorrhagic aneurysm (1, 2). ACI indicates acute progression of endarteritis, which is different from atherosclerotic strokes. Intracranial aneurysms should be excluded before antiplatelet or thrombolytic therapy to avoid life-threatening hemorrhage. Disclosure Form: Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.